OrganizationActive
Crater Lake Emergency Physicians LLC
NPI 1093386443 · Emergency Medicine Physician · Live Oak, FL
Provider details
- NPI number
- 1093386443
- Entity type
- Organization
- Primary specialty
- Emergency Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Cynthia Butcher, Officer(973) 251-1132
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1100 11th St Sw
Live Oak, FL 32064-3608
Phone: (973) 251-1132
Street-level locationGet directions
Mailing address
5565 Centerview Dr Ste 107
Raleigh, NC 27606-3563
Registry dates
- Enumerated
- 2021-07-07
- Last updated
- 2021-07-07
- Certified
- 2021-07-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.